‘Remarkable’ Outcomes Being Achieved In Unique Public/Private Sector Medication Reduction Project
A UNIQUE partnership between an NHS Trust and a Yorkshire-based private social care provider which aimed to assess and reduce medications for elderly residents is set to be rolled out nationwide after positive outcomes were achieved – including for a 101-year-woman who has undergone a “remarkable’ transformation.
In a UK first, East Lancashire NHS Hospitals Trust worked on a project with Constantia Healthcare Group looking at how anticholinergic burden (ACB) scoring could be used to reduce medications taken by the 300-plus residents living in the West Yorkshire headquartered care company’s nine residential homes in Lancashire, Yorkshire and Teesside.
These include 101-year-old Evelyn Ainsworth, who lives in the company’s Middlesbrough Grange Care Home Home, who fell regularly and spent much of her time asleep before a reduction in her medication improved her overall health and wellbeing.
Evelyn is just one of the many people to benefit from the project which has resulted in medications being reduced for dozens of residents.
ACB refers to the cumulative effect of taking multiple medications that have anticholinergic properties, meaning they block the action of acetylcholine, a neurotransmitter in the body. This burden can lead to various side effects, particularly in older adults, including cognitive impairment, falls, and increased risk of mortality.
A recent study also found that exposure to a high anticholinergic burden increased the risk of dementia in patients as young as 55.
With support from the Specialist Medicines Optimisation Care Home Team for East Lancashire NHS Hospitals Trust, Constantia Healthcare, which has its head office in Birstall, carried out assessments on each of its residents and this revealed that 131 people (42%) had an ACB score greater than 3, and 37 (34%) had an ACB score exceeding 6. In some cases, individual residents had scores as high as 19.
Medicines with anticholinergic effects are assigned and the higher the ACB score, the stronger the cognitive effect. If a score is three or greater, prompt is given to review the medicines being given as it indicates the individual is at higher risk of falls, delirium and confusion. For example, every adult with an ACB score of 3 compared to somebody with a 0 will increase their risk of falling by 50%.
Emily Whitehurst, Chief Operating Officer at Constantia Healthcare Group, said the data gathered during the project will now be shared with other social care providers, with the aim of encouraging more to carry out ACB assessments with residents.
As part of this, the company has today (12th August) launched a ‘Find Your Evelyn’ national campaign in an effort to encourage more social care providers to review medications and ACB risk. This includes the option to download a free ACB toolkit from https://constantiacarehomes.co.uk/find-your-evelyn-1/
“We are really pleased with the positive outcomes we have achieved for many of our residents, Evelyn being the perfect example,” said Emily.
“Within weeks of a medication reduction plan being put in place, she became noticeably brighter and more alert, started participating in daily activities and showing renewed interest in the world around her.
“She is a great a reminder that even in our later years, the right person-centred care and clinical insight can lead to truly life-enhancing outcomes.
“By working collaboratively with clinicians and prescribers, we have an opportunity to review, challenge, and reduce unnecessary prescribing where possible and help even more people like Evelyn.”
Jane Shanahan, Senior Medicines Optimisation Care Home Pharmacy Technician at East Lancashire Hospitals NHS Trust, said: “When patients are admitted to our hospital they all have an ACB score calculated so to see this now being adopted by a private social care provider like Constantia Healthcare is heartening and we would welcome this being rolled out across the entire sector so there is a truly joined-up approach.
“Falls are the number one reason why people are admitted into hospital for acute treatment, at a cost of nearly £3 billion to the NHS so if intervention can prevent people falling in their own homes or in a residential setting, this will greatly improve their outcomes and hopefully help older people to live well and for longer.”
